How can pharma convince GPs of new drugs’ real value?
Doctors in England are facing more and more red tape when deciding which new drugs to prescribe. Here, GP Partner Una Duffy outlines what she believes pharma sales reps should do to ensure their medicines reach patients.
With financial scrutiny from Clinical Commissioning Groups (CCGs), pressure to comply with guidelines from health watchdog NICE and an increasingly litigious patient population, GPs in England have less freedom to prescribe promising new drugs than ever before.
This means that pharma sales representatives have less influence in primary care than they did in days gone by and face-to-face visits about new products are not necessarily going to result in GPs prescribing them.
Indeed, to have any chance of success, pharma sales reps need to be talking about their products at CCG and NHS England level before they approach GPs, and GPs need to be assured that a drug has been assessed by NICE and fits into guidelines.
But what else influences GPs' prescribing intentions in this highly pressured and target-driven environment, and how should pharma respond to their changing needs? We asked GP Partner Una Duffy for her opinion.
She said: "Following confirmation that a drug fits into NICE guidelines, I want pharma sales reps to provide me with information on how it fits into the next level – i.e. what has the local secondary care and CCG decided about this drug?
"For me, the evidence used in the company's promotional material and research is not really the issue and would not grab my attention. I would be more interested in finding out whether this new drug will change my current practice and also whether it is a 'me-too', second or third line to try when the established recommended treatments have already been tried."
In the UK it's not about what the individual patient wants, as it is in some other nations, where patients regularly go to their GP demanding a particular drug, it's all about best practice and cost-effectiveness, Dr Duffy went on. In light of this, another key piece of information that she would need is how a new drug compares to other options in terms of cost.
Peer approval is also very important, hence Dr Duffy would also be keen to find out whether other local consultants and colleagues were already prescribing this drug and, if so, why?
She explained: "In these target-driven and litigious times, where complaints and legal action from patients are on the rise, GPs are heavily influenced by what their peers are prescribing, including their colleagues in secondary care.
"For example, with interchangeable products, such as the New Oral Anti-Coagulants – we'll be looking at what a patient has been prescribed by a hospital when they come to us and we will be likely to continue with that drug.
"Organisations, such as the RCGP [Royal College of General Practitioners], Asthma UK and the British Heart Foundation are also very influential and are guiding GP opinion on best practice."
So how else can pharma reps better support GPs? Dr Duffy would like to see more patient support information in print and digital formats.
She said: "That sort of information tends to be quite patchy. But it is really useful and may influence a doctor's decision to prescribe. For example, in dermatology, there are plenty of emollients on the market and some have really good information on how to use them, plus guidelines on how to look after a child's skin. This is really helpful when educating patients on how to use these products regularly."
Dr Duffy would also like to see pharma getting more involved in medical education for doctors, particularly in terms of clinical guidelines and how to put them into practice. This could include online educational resources, sponsored online learning modules and conference highlights.
About the author:
Dr Tim Ringrose is CEO, M3 Europe. He trained in nephrology and intensive care in Oxford before joining Doctors.net.uk in 2000. Tim has led the development of services provided to doctors and has had considerable experience working with a wide variety of healthcare clients to deliver market research, targeted online communications and educational programmes to doctors.
For more information on M3, the global provider of technology services in healthcare, and its European Division, which includes www.doctors.net.uk, www.mdlinx.com, and www.networksinhealth.com, please call Tim on +44 (0)1235 828400, or email tim.ringrose@eu.m3.com
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